Successful Common Carotid Interposition Graft Using Proximal Saphenous Vein in a Patient with Cervical Gunshot Injuries: A Case Report

Document Type : Case Report

Authors

1 Assistant Professor of Vascular Surgery, Department of General and Vascular Surgery Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.

2 General Surgery Resident, Department of Surgery Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.

3 School of Medicine, Shahid Beheshti University of Medical Sciences(SBMU), Tehran, Iran.

4 Trauma Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

10.30491/tm.2023.415012.1641

Abstract

Introduction: Gunshot injuries to the head and neck usually result in severe trauma due to damage to major vessels and pose challenging surgical management. A penetrating neck injury places numerous organs at a significant risk.
Presentation: We present a 39-year-old female transferred to the level I trauma center due to multiple pellet injuries to the neck and jaw.
Diagnosis: Computed tomography (CT) angiography showed the presence of multiple metal densities, an intimal flap, and a local thrombus in the left common carotid artery.
Intervention: The patient underwent surgical exploration, which revealed neck hematoma and near-total transection of the left common carotid artery. She received a carotid interposition graft (CIP) using the greater saphenous vein to reconstruct the artery.
Outcomes: Following an uneventful recovery, the patient was discharged three days after the surgery without any neurological side effects or hematoma. A follow-up CT angiography six weeks after the discharge showed a successful graft.
Conclusion: This case presents a rare scenario of a penetrating neck injury with foreign objects in zone 2, necessitating a specialized surgical approach. Therefore, it contributes to the current literature and aids surgeons in managing similar patients.

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Trauma Monthly
Volume 28, Issue 4
July and August 2023
Pages 890-895

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History

  • Receive Date: 05 September 2023
  • Revise Date: 09 September 2023
  • Accept Date: 17 September 2023

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